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(pMic f>eaft0 (Keporte 

Treasury Department, United States Marine-Hospital Service. Published in accordance 
with act of Congress approved February 15, 1893. 

Vol. XIII. Washington, D. 0., February 4, 1898. No. 5. 



UNITED STATES. 

Amendments to quarantine regulations — Inspection of certain vessels and 
baggage on and after April 1 and until November 1. 

[Circular No. — .] 

Treasury Department, 

Office of the Secretary, 

Washington, D. C, Februarys, 1898. 

To officers of the Treasury Department, State and local 

quarantine officers, consular officers, and others concerned : 
The following amendments to the Quarantine Eegulations, to be 
observed at ports and on the frontiers of the United States, are hereby 
promulgated : 

Article II, paragraph 2, exception 1, is amended to read as follows : 
Vessels arriving during certain seasons of the year, to wit, November 
1 to April 1, may be admitted to entry. 

Article II, paragraph 2, exception 2, is amended by striking out the 
words " May 1st " and inserting the words "April 1st" in lieu thereof. 

L. J. Gage, 

Secretary. 

[Reports to the Supervising Surgeon-General United States Marine-Hospital Service.] 

Report on smallpox epidemic in Alabama. 

Birmingham, Ala., January 26, 1898. 
Sir : I have the honor to give a brief report of the operations of the 
Service in Jefferson County during the present smallpox outbreak, 
which lack of time has heretofore prevented. 

On January 8 official notification was received by me of the accept- 
ance, by the authorities of Birmingham and Jefferson county, of aid 
as tendered by yourself, and on the following morning work was com- 
menced in this city with 30 inspectors. 

9 89 



February 4, 1898 



90 



Each inspector was assigned a certain territory varying in extent from 
four to eight blocks according to population, and was instructed to make 
a house-to-house canvas, entering in a notebook the address of each 
house visited, names of all inmates of each house, date of last vaccina- 
tion of each individual, whether or not such vaccination was successful, 
and to revaccinate all persons who had not been successfully vaccinated 
within the last year as evidenced by an examination of the scar in each 
case. Each room in every house was to be visited, especially in the 
negro quarters where smallpox was most prevalent, and a thorough 
search of the premises made for cases that were being concealed. 

As the principal method of the spread of the disease seemed to be 
through negro miners who constantly pass from one mining camp to 
another, and as these men usually object to vaccination and are not 
within reach of city ordinance, an attempt was made to secure coopera- 
tion of the mine owners and superintendents. A meeting was accord- 
ingly held on the morning of January 9 and another on the 10th instant. 

These meetings were attended by men whose mines and furnaces sup • 
port a population of about 40,000 persons and they agreed to assist me 
in every way possible. 

Notices were immediately published and posted at each mine and 
furnace, signed by all the firms that had entered into the agreement, 
stating that no person would be employed who refused to have himself 
and family vaccinated. 

Previous to this time an attempt had been made by superintendents 
of different companies to enforce vaccination, with the result that the 
men would leave in such numbers as to cause serious embarrassment 
from lack of laborers, and the attempt was discontinued ; as soon as 
they learn, however, from these notices, that neighboring mines would 
not give them employment unless vaccinated, desertion almost entirely 
oeased, and my inspectors have met with but little opposition in their 
work. Operations having been satisfactorily begun in Birmingham, I 
visited as rapidly as possible the remaining infected points in Jefferson 
County, and inspectors were detailed to carry on the work at the fol- 
lowing places, in the manner above indicated : Adamsville, Bessemer, 
Blue Creek (including Johns, Sumpter, and Adger), Brookside, Coal- 
berg, Dolcita, Dolomite, East Lake, Ensley, Irondale, Ishkooda, Mary 
Lee, Oxmoor, Pratt City, Thomas, Woodlawn, Woodward, and Warrior ; 
and also Talladega, in Talladega County. 

A few other towns in Jefferson County will be worked in a short 
time. Seventy-one men are now employed here and in Talladega, and 
one house-to-house inspection of Birmingham, Bessemer, and Talladega 
will be completed to-morrow and another immediately begun. 

Pesthouses have been established near Birmingham, Bessemer, and 
Talladega, and to these all cases from neighboring points are brought. 
At present they contain the following number of patients : Birming- 
ham, 129 ; Bessemer, 75 ; Talladega, 39. 

The amount of work done from January 9 to 26 by the inspecting 
oorps will be seen from the following table : 





Number 
of houses 
inspected. 

7,361 

3,183 

754 

3, 453 


Number 
of persons 
inspected. 


Number 
of persons 
vaccinated. 


Number 
of cases 
smallpox 
reported. 


Number 

of houses 

disinfected. 




31,857 
10,979 
3, 131 
12,815 


9,927 
5, 262 
2,616 
7,237 


29 
78 
41 
33 


19 




88 




12 




25 








14,751 


58,812 


25,042 


181 


144 







91 February 4, 1898 

Prom the above it will appear that smallpox is on the increase, but 
such I do not believe to be the case. The increased number of cases in 
my opinion is solely due to the fact that the inspectors have discovered 
many cases that have heretofore been concealed, many of which would 
never have been discovered but for the thorough examination of each 
house. 

As to the possible duration of the epidemic I can form no opinion 
that would be of value. Many persons have been vaccinated, but many 
others have evaded the inspectors. I hope, however, to see considerable 
improvement in the situation by the middle of February. The mayor 
of Birmingham, the commissioners of Jefferson County, and officials 
everywhere, with the exception of Pratt City, have aided and supported 
me in every way in their power. 

Eespectfully, yours, G. M. Magruder, 

Passed Assistant-Surgeon, TJ. 8. M. H. 8. 

Smallpox in Pinckard, Ala. 

Pinckard, Ala., January 28, 1898. 
Sir : We are in the midst of an epidemic of smallpox, and unable to 
down the disease. Kindly use your influence to have us put under 
United States quarantine laws. The disease is becoming serious, and I 
hope that you will lose no time in extending us your assistance. 
Hoping to hear from you promptly, 

I am, yours, very truly, J. W. Harris, 

Mayor. 
Hon. H. D. Clayton, M. C. 

Smallpox in Shelby, Ala. 

[Telegram.] 

Columbiana, Ala., January 28, 1898. 
One case of smallpox in Shelby, a mining town. Several persons 
exposed. 

T>. E. McMillan. 

Smallpox decreasing in Washington County, Florida. 

Jacksonville, Pla., January 81, 1898. 
Sir : Supplementing my letter of January 24 wherein I notified your 
office of the existence of smallpox in Washington County, Pla., per- 
mit me to state that at this writing the situation thereat is very much 
improved. There seems to be very few additional cases, and vaccination 
is proceeding rapidly and thoroughly. I omitted to state in my former 
letter that the disease was distinctly traced to the State of Alabama, a 
fact which I regret not having given prominence to in the said fore- 
going communication. 

Very truly, yours, Joseph Y. Porter, 

State Health Officer, Florida. 



The above letter was referred to the Supervising Surgeon-General 
TJ. S. Marine-Hospital Service, who telegraphed to the passed assistant 
surgeon in charge of the smallpox epidemic in Alabama, requesting 
that he visit the locality named and report upon same.